First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 23-0485.01 Sarah Lozano x3858
SENATE BILL 23-081
Senate Committees House Committees
Health & Human Services
Finance
A BILL FOR AN ACT
C
ONCERNING ALLOWING EQUITA BLE PATIENT ACCESS TO MEDICAL101
MARIJUANA IN COLORADO.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
Current law allows a physician to submit documentation to the
department of public health and environment (department) stating that a
patient has a debilitating medical condition or disabling medical condition
and may benefit from the use of medical marijuana. The bill clarifies that
the physician is submitting a recommendation to the department rather
than a certification or authorization.
SENATE SPONSORSHIP
Van Winkle and Jaquez Lewis,
HOUSE SPONSORSHIP
Soper and Snyder,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. The bill removes the following requirements for a physician's
recommendation to the department:
! The physician's federal drug enforcement agency number;
! The maximum THC potency level of the medical marijuana
product;
! The recommended medical marijuana product;
! The patient's daily authorized quantity of the medical
marijuana product; and
! Directions for use of the medical marijuana product.
The bill allows a physician to establish a bonafide
physician-patient relationship remotely via video or telephone conference
if the patient is:
! 21 years of age or older;
! Under 18 years of age; or
! 18 years of age or older but under 21 years of age and the
patient received a medical marijuana recommendation prior
to 18 years of age.
The bill clarifies that a patient must only present a uniform
certification form completed by a recommending physician to a medical
marijuana store if the patient seeks to purchase more than the statutorily
allowed limit of medical marijuana products.
Current law limits the amount of medical marijuana concentrate
that a patient may purchase in a single day to 8 grams. The bill increases
that limitation to 40 grams, but limits the total amount that a patient can
purchase in a 30-day period to the equivalent of 8 grams per day. Current
law limits the combined amount of medical marijuana products that a
patient may purchase in a single day to 20,000 milligrams. The bill adds
an exception to that limitation for nonedible, nonpsychoactive medical
marijuana products.
Current law limits the amount of medical marijuana concentrate
that a patient 18 years of age or older but under 21 years of age may
purchase in a single day to 2 grams. The bill allows a patient that is 18
years of age or older but under 21 years of age and had a registry
identification card issued by the department prior to 18 years of age to
purchase in a single day up to 8 grams of medical marijuana concentrate.
The bill clarifies that when a physician issues a uniform
certification form to a patient 18 years of age or older, the physician may
consider whether the patient had a registry identification card issued by
the department prior to 18 years of age as a factor in recommending that
the patient be allowed to purchase more than the statutorily allowed
quantities of medical marijuana products.
The bill allows a retail marijuana store to sell retail marijuana
products to patients at the statutorily allowed limit for medical marijuana
products and registered primary caregivers 21 years of age or older who
present a registry identification card issued by the department. The bill
SB23-081
-2- also allows a registered primary caregiver to purchase retail marijuana
products for a patient who is under 21 years of age at the applicable
statutorily allowed limit for medical marijuana products for patients under
21 years of age.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 25-1.5-106, amend2
(2)(a.5)(I), (5)(b)(I), (5)(b)(II) introductory portion, (5)(b)(II)(C),3
(5)(b)(II)(H), (5)(b)(III), and (5)(c); repeal (5)(b)(II)(D), (5)(b)(II)(E),4
(5)(b)(II)(F), and (5)(b)(II)(G); and add (5)(b)(II.5), (5)(h), and (5)(i) as5
follows:6
25-1.5-106. Medical marijuana program - powers and duties7
of state health agency - rules - medical review board - medical8
marijuana program cash fund - subaccount - created - "Ethan's9
Law" - definitions - repeal. (2) Definitions. In addition to the10
definitions set forth in section 14 (1) of article XVIII of the state11
constitution, as used in this section, unless the context otherwise requires:12
(a.5) "Bona fide physician-patient relationship", for purposes of13
the medical marijuana program, means:14
(I) A physician and a patient have a treatment or counseling15
relationship, in the course of which the physician has completed the16
in-person A full assessment of the patient's medical history, including an17
assessment of ASSESSING the patient's medical and mental health history18
to determine whether the patient has a medical or mental health issue that19
could be exacerbated by the use of medical marijuana and reviewing a20
previous diagnosis,
IF AVAILABLE, for a debilitating or disabling medical21
condition, and
A FULL ASSESSMENT OF THE PATIENT 'S current medical22
condition, including an appropriate personal physical examination. If the
23
SB23-081-3- recommending physician is not the patient's primary care physician, the1
recommending physician shall review the existing records of the2
diagnosing physician or a licensed mental health provider. This3
subsection (2)(a.5)(I) does not require a mental health examination prior4
to making a recommendation.5
(5) Physicians. A physician who certifies a debilitating medical6
condition or disabling medical condition for an applicant to the medical7
marijuana program shall comply with all of the following requirements:8
(b) (I) (A) After a physician, who has a bona fide9
physician-patient relationship with the patient applying for the medical10
marijuana program, determines, for the purposes of making a11
recommendation, that the patient has a debilitating medical condition or12
disabling medical condition and that the patient may benefit from the use13
of medical marijuana, the physician shall certify to the state health agency14
that the patient has a debilitating medical condition or disabling medical15
condition and that the patient may benefit from the use of medical16
marijuana. If the physician certifies that the patient would benefit from17
the use of medical marijuana based on a chronic or debilitating disease or18
medical condition or disabling medical condition, the physician shall19
specify the chronic or debilitating disease or medical condition or20
disabling medical condition and, if known, the cause or source of the21
chronic or debilitating disease or medical condition or disabling medical22
condition.23
(B) A physician's authorization RECOMMENDATION for medical24
marijuana must be in compliance with the provisions of this section, any25
rules promulgated pursuant to this section, the physician's respective26
practice act, article 220 of title 12 and any rules promulgated pursuant to27
SB23-081
-4- that article for a dentist, article 240 of title 12 and any rules promulgated1
pursuant to that article, and article 255 of title 12 and any rules2
promulgated pursuant to that article for an advanced practice registered3
nurse.4
(II) The certification RECOMMENDATION must include the5
following:6
(C) The authorizing RECOMMENDING physician's name AND7
address; and federal drug enforcement agency number;8
(D) The maximum THC potency level of medical marijuana being9
recommended;10
(E) The recommended product, if any;11
(F) The patient's daily authorized quantity, if such quantity12
exceeds the maximum statutorily allowed amount for the patient's age;13
(G) Directions for use; and14
(H) The authorizing RECOMMENDING physician's signature.15
(II.5) T
HE RECOMMENDATION MAY INCLUDE THE FOLLOWING :16
(A) T
HE MAXIMUM THC POTENCY LEVEL OF MEDICAL MARIJUANA17
BEING RECOMMENDED ;18
(B) T
HE RECOMMENDED PRODUCT , IF ANY;19
(C) T
HE PATIENT'S DAILY RECOMMENDED QUANTITY ; AND20
(D) D
IRECTIONS FOR USE, IF ANY.21
(III) The authorizing
RECOMMENDING physician shall provide the22
patient with a copy of the certification RECOMMENDATION .23
(c) The physician shall maintain a record-keeping system,24
including a copy of the certification RECOMMENDATION , for all patients25
for whom the physician has authorized RECOMMENDED the medical use26
of marijuana, and, pursuant to an investigation initiated pursuant to27
SB23-081
-5- section 12-240-125, the physician shall produce such medical records to1
the Colorado medical board after redacting any patient or primary2
caregiver identifying information. The physician shall maintain the3
medical records of the patient's visit, and the physician shall,
WITH THE4
PATIENT'S PERMISSION, respond to a treating physician's request for5
medical records to treat the patient with the certification with the patient's
6
permission RECOMMENDATION .7
(h) A
PHYSICIAN MAY TREAT, COUNSEL, DIAGNOSE, AND CONDUCT8
APPROPRIATE PERSONAL PHYSICAL EXAMINATIONS IN PERSON OR9
REMOTELY VIA TELEPHONE OR VIDEO CONFERENCE TO ESTABLISH A10
BONAFIDE PHYSICIAN-PATIENT RELATIONSHIP WITH A PATIENT IF THE11
PATIENT IS UNDER EIGHTEEN YEARS OF AGE OR TWENTY -ONE YEARS OF12
AGE OR OLDER. THE INITIAL PERSONAL PHYSICAL EXAMINATION FOR A13
PATIENT EIGHTEEN YEARS OF AGE OR OLDER BUT UNDER TWENTY -ONE14
YEARS OF AGE MUST BE IN PERSON UNLESS THE PATIENT IS HOMEBOUND OR15
QUALIFIES FOR A SIGNIFICANT GEOGRAPHIC HARDSHIP ; ANY SUBSEQUENT16
EXAMINATIONS MAY BE CONDUCTED VIA TELEPHONE OR VIDEO17
CONFERENCE. IF A PATIENT WHO IS EIGHTEEN YEARS OF AGE OR OLDER BUT18
UNDER TWENTY-ONE YEARS OF AGE RECEIVED A RECOMMENDATION FOR19
MEDICAL MARIJUANA PRIOR TO EIGHTEEN YEARS OF AGE , THE PATIENT IS20
NOT REQUIRED TO RECEIVE AN IN -PERSON PERSONAL PHYSICAL21
EXAMINATION TO ESTABLISH A BONAFIDE PHYSICIAN -PATIENT22
RELATIONSHIP WITH A PHYSICIAN.23
(i) N
OTWITHSTANDING ANY LAW TO THE CONTRARY , A PHYSICIAN24
IS NOT SUBJECT TO ANY CRIMINAL, CIVIL, OR ADMINISTRATIVE PENALTIES25
OR SANCTIONS FOR ISSUING A UNIFORM CERTIFICATION FORM , AS DEFINED26
IN SECTION 44-10-501 (15), TO A PATIENT OR REGISTERED PRIMARY27
SB23-081
-6- CAREGIVER.1
SECTION 2. In Colorado Revised Statutes, 44-10-501, amend2
(1)(b)(II), (4)(a)(III), (4)(c), (10)(a), and (10)(b)(III); and add (4)(d), (13),3
(14), and (15) as follows:4
44-10-501. Medical marijuana store license - statutorily5
allowed quantities - uniform certification form - definitions.6
(1) (b) (II) In the event of a temporary outage of the seed-to-sale tracking7
system, a medical marijuana store:8
(A) May rely upon the physician's certification required by section9
25-1.5-106 PATIENT'S UNIFORM CERTIFICATION FORM IF THE PATIENT IS10
SEEKING TO PURCHASE MORE THAN THE STATUTORILY ALLOWED11
QUANTITIES DESCRIBED IN SUBSECTION (10) OF THIS SECTION; and12
(B) Is not responsible for any unintentional sale
THAT OCCURS13
DURING THE OUTAGE in excess of the authorized quantity limit that occurs
14
during the outage, provided however that STATUTORILY ALLOWED15
QUANTITIES DESCRIBED IN SUBSECTION (10) OF THIS SECTION OR THE16
QUANTITIES LISTED ON THE PATIENT'S UNIFORM CERTIFICATION FORM, SO17
LONG AS the medical marijuana store uploads its sales data into the18
seed-to-sale tracking system as soon as reasonably practical after the end19
of the outage.20
(4) (a) Prior to initiating a sale, the employee of the medical21
marijuana store making the sale shall verify:22
(III) That the patient's or caregiver's purchase will not exceed the23
patient's daily authorized quantity limit STATUTORILY ALLOWED24
QUANTITIES DESCRIBED IN SUBSECTION (10) OF THIS SECTION or the25
amount listed on the patient's certification UNIFORM CERTIFICATION FORM,26
whichever is greater, and the purchase aligns with the purchase authority27
SB23-081
-7- information in the seed-to-sale tracking system.1
(c) If the patient seeks to purchase more than the statutorily2
allowed daily authorized limit QUANTITIES of concentrate for the patient's3
age group
DESCRIBED IN SUBSECTION (10) OF THIS SECTION, the patient4
shall present the patient's certification
UNIFORM CERTIFICATION FORM at5
the time of purchase, and the medical marijuana store shall not exceed6
THE statutorily allowed quantities or the quantities specified in the7
UNIFORM certification FORM, WHICHEVER IS GREATER.8
(d) N
OTWITHSTANDING ANY LAW TO THE CONTRARY , IF THE9
PATIENT OR CAREGIVER IS SEEKING TO PURCHASE MEDICAL MARIJUANA10
PRODUCTS AT OR BELOW THE STATUTORILY ALLOWED QUANTITIES11
DESCRIBED IN SUBSECTION (10) OF THIS SECTION, A MEDICAL MARIJUANA12
STORE SHALL NOT REQUIRE THE PATIENT OR CAREGIVER TO PRESENT ANY13
DOCUMENTATION OTHER THAN THE DOCUMENTATION DESCRIBED IN14
SUBSECTIONS (4)(a)(I) AND (4)(a)(II) OF THIS SECTION.15
(10) (a) Except as provided in subsection (10)(b) of this section,16
a medical marijuana store shall not,
IN A SINGLE BUSINESS DAY, sell,17
individually or in any combination, more than two ounces of medical18
marijuana flower, eight
FORTY grams of medical marijuana concentrate,19
or medical marijuana products containing a combined total of twenty20
thousand milligrams to a patient; in a single business day EXCEPT THAT21
THE LIMIT DOES NOT APPLY TO NONEDIBLE, NONPSYCHOACTIVE MEDICAL22
MARIJUANA PRODUCTS, INCLUDING OINTMENTS, LOTIONS, BALMS, AND23
OTHER NONTRANSDERMAL TOPICAL PRODUCTS . EXCEPT AS PROVIDED IN24
SUBSECTION (10)(b) OF THIS SECTION, A MEDICAL MARIJUANA STORE25
SHALL NOT SELL, INDIVIDUALLY OR IN ANY COMBINATION, MORE THAN THE26
EQUIVALENT OF EIGHT GRAMS OF MEDICAL MARIJUANA CONCENTRATE PER27
SB23-081
-8- DAY TO A PATIENT WITHIN A THIRTY-DAY PERIOD.1
(b) (III) (A) A medical marijuana store or medical marijuana2
stores shall not sell any more than eight FORTY grams of medical3
marijuana concentrate to a patient in a single day
OR THE EQUIVALENT OF4
EIGHT GRAMS OF MEDICAL MARIJUANA CONCENTRATE PER DAY TO A5
PATIENT WITHIN ANY THIRTY-DAY PERIOD; except that this subsection6
(10)(b) does not apply if the patient is homebound, if the physician's
7
certification PATIENT'S UNIFORM CERTIFICATION FORM specifically states8
that the patient needs more than eight FORTY grams of medical marijuana9
concentrate,
OR if it would be a significant physical or geographic10
hardship for the patient to make a daily purchase. or if the patient had a
11
registry identification card prior to eighteen years of age.12
(B) Notwithstanding the provisions of subsection (10)(b)(III)(A)13
of this section, if the A patient is eighteen to twenty years of age OR14
OLDER BUT UNDER TWENTY-ONE YEARS OF AGE, a medical marijuana store15
or medical marijuana stores shall not sell any more than two grams of16
medical marijuana concentrate to a THE patient in a single day; except that17
this subsection (10)(b) does not apply if the patient is homebound, if the18
physician's certification PATIENT'S UNIFORM CERTIFICATION FORM19
specifically states the patient needs more than two grams of medical20
marijuana concentrate,
OR if it would be a significant physical or21
geographic hardship for the patient to make a daily purchase. or if the
22
patient had a registry identification card prior to eighteen years of age.23
(C) N
OTWITHSTANDING SUBSECTION (10)(b)(III)(B) OF THIS24
SECTION, IF A PATIENT IS EIGHTEEN YEARS OF AGE OR OLDER BUT UNDER25
TWENTY-ONE YEARS OF AGE AND THE PATIENT HAD A REGISTRY26
IDENTIFICATION CARD PRIOR TO EIGHTEEN YEARS OF AGE , A MEDICAL27
SB23-081
-9- MARIJUANA STORE MAY SELL UP TO EIGHT GRAMS OF MEDICAL MARIJUANA1
CONCENTRATE TO THE PATIENT IN A SINGLE DAY ; EXCEPT THAT THIS2
SUBSECTION (10)(b)(III)(C) DOES NOT APPLY IF THE PATIENT'S UNIFORM3
CERTIFICATION FORM SPECIFICALLY STATES THAT THE PATIENT NEEDS4
MORE THAN EIGHT GRAMS OF MEDICAL MARIJUANA CONCENTRATE IN A5
SINGLE DAY.6
(13) W
HEN ISSUING A UNIFORM CERTIFICATION FORM TO A PATIENT7
EIGHTEEN YEARS OF AGE OR OLDER , A PHYSICIAN MAY CONSIDER8
WHETHER THE PATIENT HAD A REGISTRY IDENTIFICATION CARD PRIOR TO9
EIGHTEEN YEARS OF AGE AS A FACTOR IN RECOMMENDING THAT THE10
PATIENT OR REGISTERED PRIMARY CAREGIVER BE ALLOWED TO PURCHASE11
MORE THAN THE STATUTORILY ALLOWED QUANTITIES OF MEDICAL12
MARIJUANA PRODUCTS DESCRIBED IN SUBSECTION (10) OF THIS SECTION.13
(14) N
OTWITHSTANDING ANY LAW TO THE CONTRARY , A MEDICAL14
MARIJUANA STORE LICENSEE IS NOT SUBJECT TO ANY CRIMINAL , CIVIL, OR15
ADMINISTRATIVE PENALTIES OR SANCTIONS FOR ACCEPTING A UNIFORM16
CERTIFICATION FORM PROVIDED BY A PATIENT OR REGISTERED PRIMARY17
CAREGIVER.18
(15) A
S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE19
REQUIRES, "UNIFORM CERTIFICATION FORM" MEANS THE FORM DEVELOPED20
BY THE STATE LICENSING AUTHORITY FOR PHYSICIANS TO RECOMMEND A21
PATIENT OR REGISTERED PRIMARY CAREGIVER BE ABLE TO PURCHASE22
MORE THAN THE STATUTORILY ALLOWED QUANTITIES OF MEDICAL23
MARIJUANA PRODUCTS DESCRIBED IN SUBSECTION (10) OF THIS SECTION.24
SECTION 3. In Colorado Revised Statutes, 44-10-601, add (18)25
as follows:26
44-10-601. Retail marijuana store license - rules - definitions.27
SB23-081
-10- (18) (a) NOTWITHSTANDING ANY LAW TO THE CONTRARY , IF A PATIENT1
OR REGISTERED PRIMARY CAREGIVER PRESENTS A VALID REGISTRY2
IDENTIFICATION CARD ISSUED PURSUANT TO SECTION 25-1.5-106 (9) AND3
THE PATIENT OR REGISTERED PRIMARY CAREGIVER IS TWENTY -ONE YEARS4
OF AGE OR OLDER, A RETAIL MARIJUANA STORE MAY SELL RETAIL5
MARIJUANA PRODUCTS AT THE STATUTORILY ALLOWED QUANTITIES FOR6
MEDICAL MARIJUANA PRODUCTS DESCRIBED IN SECTION 44-10-501 (10) TO7
THE PATIENT OR REGISTERED PRIMARY CAREGIVER .8
(b) N
OTWITHSTANDING ANY LAW TO THE CONTRARY , IF A9
REGISTERED PRIMARY CAREGIVER PRESENTS A VALID REGISTRY10
IDENTIFICATION CARD ISSUED PURSUANT TO SECTION 25-1.5-106 (9) AND11
IS TWENTY-ONE YEARS OF AGE OR OLDER , A RETAIL MARIJUANA STORE12
MAY SELL RETAIL MARIJUANA PRODUCTS AT THE STATUTORILY ALLOWED13
QUANTITIES FOR MEDICAL MARIJUANA PRODUCTS DESCRIBED IN SECTION14
44-10-501
(10) TO THE REGISTERED PRIMARY CAREGIVER FOR THE15
PRIMARY CAREGIVER'S PATIENT UNDER TWENTY-ONE YEARS OF AGE.16
SECTION 4. Safety clause. The general assembly hereby finds,17
determines, and declares that this act is necessary for the immediate18
preservation of the public peace, health, or safety.19
SB23-081
-11-